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General NPI Number Information
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NPI Number | 1881387504
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Entity Type | Organization
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Legal Business Name | YOURPATH CARE, PLLC
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Dates
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Enumeration Date | 05/30/2023
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 700 RAYMOND AVE STE 130
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City | SAINT PAUL
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State | MN
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Zip | 55114-1778
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Country | US
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Telephone | 612-895-1510
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Fax |
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Provider Business Mailing Address
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Address Line | 700 RAYMOND AVE STE 130
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City | SAINT PAUL
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State | MN
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Zip | 55114-1778
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Country | US
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Telephone | 612-895-1510
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEPHEN MICHAEL DELISI
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Credential | MD
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Telephone | 612-699-7778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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